1. Physician Assistant Project Funding Models an Ontario Perspective October 5, 2008

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3. 3 Mechanisms Principles of funding supervising physicians developed through the Liability and Compensation Subcommittee Funding determined through a bilateral process (MOHLTC and OMA) through the PIHT working group and Physician Services Committee

4. 4 Demonstration Projects Emergency Department Demonstration Project Hospitals Community Health Centres (CHC) OMA Physician Employed model (PEPA) Monies for the programs are flowed from the MOHLTC to each of the lead agencies, Ontario Hospital Association, Association for Community Health Centres and Ontario Medical Association

5. 5 PA Associated Costs All programs are reimbursed for the costs associated with recruitment, hiring and relocation of the physician assistant All sites are reimbursed for the clinical integration process for the IMGs and for the orientation for the PAs Hospitals compensation for the PAs salary on a declining amount – 100% of the salary and ending 25% PAs salary Both CHCs and physicians in PEPA projects receive 100% of the PAs salary and benefits (at 23%) whether IMG or certified PA

6. 6 PA Compensation PAs will be paid $75,000, $80,000 or $85,000 depending on experience All PAs will be paid according to the same scale Benefits should mirror the benefits provided to other employees Liability Insurance covered

7. 7 Supervising Physicians Given the anticipated amount of work physicians would be involved in during the demonstration projects and the OMA’s policy that physicians should not be adversely impacted by the introduction of PA’s; there was a bilateral agreement to compensate physicians for their supervisory activities which would include assessing the PAs competency, development of medical directives and ongoing evaluation process. $72,000 over the 24 month period Compensation frontend loaded recognizing the intensity of supervision – $5,000/month first 3 months, $3,000/month next 15 months and $2,000 for the last 6 months

8. 8 Supervising Physicians Receive $5000 completion bonus Physicians involved in the clinical component of IMG PA integration program were paid $5500 for the 2 months of the clinical component of the program Salaried supervising physicians at the Community Health Centres receive $1500/month for the duration of the demonstration project and the $5000 completion bonus

9. 9 Additional Liability protection is covered by the MOHLTC CAPA competency exams – expenses for the PAs; incentive of $1000 from those recruited from US or IMG stream to take CAPA exam